STROKE-tPA MEDICATIONS
SUMMARY
1. Agents: alteplase (dose: 0.9 mg/kg, max: 90 mg) and techneplase, desmoteplase.
2. 4.5 hours from when last know to be well or from midpoint of sleep[1].
3. 9 hours if there is perfusion mismatch[2].
4. If no reperfusion for ischemia then commence anti-platelet agent urgently.
5. Thrombolysis is possible whilst awaiting clot retrieval.
Reference(s)
- ↑ Parsons, M., Spratt, N., Bivard, A., Campbell, B., Chung, K., Miteff, F., O'Brien, B., Bladin, C., McElduff, P., Allen, C. and Bateman, G., 2012. A randomized trial of tenecteplase versus alteplase for acute ischemic stroke. New England Journal of Medicine, 366(12), pp.1099-1107.
- ↑ Campbell, B.C., Ma, H., Ringleb, P.A., Parsons, M.W., Churilov, L., Bendszus, M., Levi, C.R., Hsu, C., Kleinig, T.J., Fatar, M. and Leys, D., 2019. Extending thrombolysis to 4· 5–9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data. The Lancet, 394(10193), pp.139-147.
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
